Skip to main content
Top
Published in: Obesity Surgery 9/2013

01-09-2013 | Original Article

Comparative Review of the Safety and Efficacy of Ferric Carboxymaltose Versus Standard Medical Care for the Treatment of Iron Deficiency Anemia in Bariatric and Gastric Surgery Patients

Authors: Margaret Malone, Charles Barish, Andy He, David Bregman

Published in: Obesity Surgery | Issue 9/2013

Login to get access

Abstract

Background

Iron deficiency anemia (IDA) is a common finding in patients after bariatric surgery. The cause is multifactorial including reduced oral iron intake and malabsorption. While many patients can be managed with oral supplements, parenteral iron may be needed to restore and maintain iron stores.

Methods

Subjects who had previous bariatric surgery and had participated in phase 3 industry-sponsored clinical trials designed to assess the safety and/or efficacy of intravenous (IV) ferric carboxymaltose (FCM) were retrospectively selected from the databases of each of these studies. Demographic data, efficacy measures [hemoglobin, ferritin, and transferrin saturation (TSAT)], and adverse events were compared between FCM and other agents utilized as comparators in the trials.

Results

Two hundred eighty-one subjects from the intention to treat (ITT) population were included (mean age 49 years, BMI 33 kg/m2, including 253 females). FCM had similar or improved efficacy (p < 0.05) in terms of increasing hemoglobin, ferritin, and TSAT values when compared to other iron products used as standard of care for IDA. The incidence of adverse events in the FCM patients (n = 123) versus patients receiving any IV iron (n = 126) was 61 and 56.3 %, respectively. The adverse events were similar in both groups with the exception of a transient decrease in serum phosphate which was observed more frequently in the FCM group.

Conclusions

These data in post-bariatric surgery IDA patients suggest that FCM is a safe and effective alternative to existing iron products permitting higher and thus less frequent individual doses.
Literature
2.
go back to reference Kaidar-Person O, Person B, Szomstein S, et al. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Obes Surg. 2008;1028–34. Kaidar-Person O, Person B, Szomstein S, et al. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Obes Surg. 2008;1028–34.
3.
go back to reference Skroubis G, Sakellaropoulos G, Pouggouras K, et al. Comparison of nutritional deficiencies after Roux-en-Y gastric bypass and after biliopancreatic diversion. Obes Surg. 2002;12:551–8.PubMedCrossRef Skroubis G, Sakellaropoulos G, Pouggouras K, et al. Comparison of nutritional deficiencies after Roux-en-Y gastric bypass and after biliopancreatic diversion. Obes Surg. 2002;12:551–8.PubMedCrossRef
4.
go back to reference Dalcanale L, Oliveira CP, Faintuch J, et al. Long term nutritional outcome after gastric bypass. Obes Surg. 2010;20(2):181–7.PubMedCrossRef Dalcanale L, Oliveira CP, Faintuch J, et al. Long term nutritional outcome after gastric bypass. Obes Surg. 2010;20(2):181–7.PubMedCrossRef
5.
go back to reference von Drygalski A, Andris DA, Nuttleman PR, et al. Anemia after bariatric surgery cannot be explained by iron deficiency alone: results of a large cohort study. Surg Obes Relat Dis. 2011;7:151–6.CrossRef von Drygalski A, Andris DA, Nuttleman PR, et al. Anemia after bariatric surgery cannot be explained by iron deficiency alone: results of a large cohort study. Surg Obes Relat Dis. 2011;7:151–6.CrossRef
6.
go back to reference Ruz M, Carrasco F, Rojas P, et al. Iron absorption and iron status are reduced after Roux-en-Y gastric bypass. Am J Clin Nutr. 2009;90(3):527–32.PubMedCrossRef Ruz M, Carrasco F, Rojas P, et al. Iron absorption and iron status are reduced after Roux-en-Y gastric bypass. Am J Clin Nutr. 2009;90(3):527–32.PubMedCrossRef
7.
go back to reference Brolin RE, LaMarca LB, Kenler HA, et al. Malabsorptive gastric bypass in patients with super obesity. J Gastrointest Surg. 2002;6:195–203.PubMedCrossRef Brolin RE, LaMarca LB, Kenler HA, et al. Malabsorptive gastric bypass in patients with super obesity. J Gastrointest Surg. 2002;6:195–203.PubMedCrossRef
8.
go back to reference Brolin RE, Gorman JH, Gorman RC, et al. Are vitamin B12 and folate deficiency clinically important after Roux-en-Y gastric bypass? J Gastrointest Surg. 1998;2:436–42.PubMedCrossRef Brolin RE, Gorman JH, Gorman RC, et al. Are vitamin B12 and folate deficiency clinically important after Roux-en-Y gastric bypass? J Gastrointest Surg. 1998;2:436–42.PubMedCrossRef
9.
go back to reference Rhode BM, Shustik C, Christou NV, et al. Iron absorption and therapy after gastric bypass. Obes Surg. 1999;9:17–21.PubMedCrossRef Rhode BM, Shustik C, Christou NV, et al. Iron absorption and therapy after gastric bypass. Obes Surg. 1999;9:17–21.PubMedCrossRef
10.
go back to reference Vargas-Ruiz AG, Hernandez-Rivera G. Prevalence of iron, folate, and vitamin B12 deficiency anemia after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2008;18:288–93.PubMedCrossRef Vargas-Ruiz AG, Hernandez-Rivera G. Prevalence of iron, folate, and vitamin B12 deficiency anemia after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2008;18:288–93.PubMedCrossRef
12.
go back to reference Tussing-Humphreys LM, Nemeth E, Fantuzzi G, et al. Decreased serum hepcidin, inflammation, and improved functional iron status in obese pre-menopausal women six-months post-restrictive bariatric surgery. Obesity. 2010;18:2010–6.PubMedCrossRef Tussing-Humphreys LM, Nemeth E, Fantuzzi G, et al. Decreased serum hepcidin, inflammation, and improved functional iron status in obese pre-menopausal women six-months post-restrictive bariatric surgery. Obesity. 2010;18:2010–6.PubMedCrossRef
13.
go back to reference Cheng HL, Bryant C, Cook R, et al. The relationship between obesity and hypoferraemia in adults: a systematic review. Obes Rev. 2012;13:150–61.PubMedCrossRef Cheng HL, Bryant C, Cook R, et al. The relationship between obesity and hypoferraemia in adults: a systematic review. Obes Rev. 2012;13:150–61.PubMedCrossRef
14.
go back to reference Mechanick JI, Kushner RF, Sugerman HJ, et al. AACE/TOS/ASMBS medical guidelines for clinical practice for the peri-operative nutritional, metabolic and nonsurgical support of the bariatric surgery patient. Endocr Pract. 2008;14:318–36.PubMedCrossRef Mechanick JI, Kushner RF, Sugerman HJ, et al. AACE/TOS/ASMBS medical guidelines for clinical practice for the peri-operative nutritional, metabolic and nonsurgical support of the bariatric surgery patient. Endocr Pract. 2008;14:318–36.PubMedCrossRef
15.
go back to reference Lyseng-Williamson KA, Keating GM. Ferric carboxymaltose: a review of its use in iron deficiency anemia. Drugs. 2009;69:739–56.PubMedCrossRef Lyseng-Williamson KA, Keating GM. Ferric carboxymaltose: a review of its use in iron deficiency anemia. Drugs. 2009;69:739–56.PubMedCrossRef
16.
go back to reference Barish CF, Koch T, Butcher A, et al. Safety and efficacy of intravenous ferric carboxymaltose (750 mg) in the treatment of iron deficiency anemia: two randomized controlled trials. Anemia. 2012;2012:172104.PubMedCrossRef Barish CF, Koch T, Butcher A, et al. Safety and efficacy of intravenous ferric carboxymaltose (750 mg) in the treatment of iron deficiency anemia: two randomized controlled trials. Anemia. 2012;2012:172104.PubMedCrossRef
19.
go back to reference DeFilipp Z, Lister J, Gagne D, et al. Intravenous iron replacement for persistent iron deficiency anemia after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2013;9(1):129–32.PubMedCrossRef DeFilipp Z, Lister J, Gagne D, et al. Intravenous iron replacement for persistent iron deficiency anemia after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2013;9(1):129–32.PubMedCrossRef
20.
go back to reference Van Wyck DB, Martens MG, Seid J, et al. Intravenous ferric carboxymaltose compared with oral iron in the treatment of post partum anemia: a randomized controlled trial. Obstet Gynecol. 2007;110(21):267–78.PubMedCrossRef Van Wyck DB, Martens MG, Seid J, et al. Intravenous ferric carboxymaltose compared with oral iron in the treatment of post partum anemia: a randomized controlled trial. Obstet Gynecol. 2007;110(21):267–78.PubMedCrossRef
21.
go back to reference Schouten BJ, Hunt PJ, Livesey JH, et al. FG23 elevation and hypophosphatemia after iron polymaltose: a prospective study. J Clin Endocrinol Metab. 2009;94(7):2332–7.PubMedCrossRef Schouten BJ, Hunt PJ, Livesey JH, et al. FG23 elevation and hypophosphatemia after iron polymaltose: a prospective study. J Clin Endocrinol Metab. 2009;94(7):2332–7.PubMedCrossRef
Metadata
Title
Comparative Review of the Safety and Efficacy of Ferric Carboxymaltose Versus Standard Medical Care for the Treatment of Iron Deficiency Anemia in Bariatric and Gastric Surgery Patients
Authors
Margaret Malone
Charles Barish
Andy He
David Bregman
Publication date
01-09-2013
Publisher
Springer US
Published in
Obesity Surgery / Issue 9/2013
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-013-0939-6

Other articles of this Issue 9/2013

Obesity Surgery 9/2013 Go to the issue